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Carondelet to Pay $35M to Settle Fraud Allegations

John Commins, for HealthLeaders Media, August 20, 2014

The agreement reached between the Department of Justice and not-for-profit Carondelet Health Network to resolve whistleblower allegations is Arizona's largest False Claims Act recovery, says the US Attorney handling the case.


Beckmann

James Beckmann
CEO and President, Cardondelet Health

For the second time this month a hospital chain has agreed to pay tens of millions of dollars to the federal government to resolve Medicare fraud allegations.

Arizona's Carondelet Health Network has agreed to pay the federal government $35 million to resolve whistleblower allegations involving fraudulent inpatient billings to Medicare and other federal healthcare programs.

Federal prosecutors said that from April 7, 2004, through Dec. 31, 2011, Carondelet St. Mary's Hospital and Carondelet St. Joseph's Hospital improperly billed Medicare, the Federal Employees Health Benefit Program, and Arizona's Medicaid program for inpatient rehabilitation services that should have been done in a less-costly setting.

"Shortly before becoming aware of the United States' investigation, Carondelet disclosed to the government some inpatient rehabilitation overpayments and tendered a substantial repayment," says a Department of Justice media release.


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"However, based on its investigation, the United States had concerns about the nature of Carondelet's disclosure, including concerns that the disclosure and the repayment Carondelet tendered were not timely, complete, or adequate."

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